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      Validity of ankylosing spondylitis diagnoses in The Health Improvement Network : Ankylosing Spondylitis Diagnostic Validity

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          Abstract

          Because ankylosing spondylitis (AS) is uncommon, large medical record databases offer important opportunities for pharmacoepidemiologic research. However, the validity of AS diagnoses recorded by a general practitioner (GP) is unknown. We assessed the validity of algorithms for identifying AS in The Health Improvement Network (THIN).

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          Validation of information recorded on general practitioner based computerised data resource in the United Kingdom.

          L E Derby, S Jick, H Jick (1991)
          To determine the extent of agreement between clinical information recorded on surgery computers of selected general practitioners and similar information in manual records of letters received from hospital consultants and kept in the general practitioners' files. Hospital consultants' letters in the manual records of selected general practitioners were photocopied and the consultants' clinical diagnoses were compared with diagnoses recorded on computer. General practices in the United Kingdom using computers provided by VAMP Health for recording clinical information. 2491 patients who received one of three non-steroidal anti-inflammatory drugs and who attended 58 practices whose computer recorded data were considered after a preliminary review to be of satisfactory quality. Among 1191 patients for whom consultants' letters were forwarded a clinical diagnosis reflecting the diagnosis noted on a consultant letter was present on the computer record for 1038 (87%). Clinical information available on the computer records of the general practitioners who participated in this study is satisfactory for many clinical studies.
          Article 0 comments Cited 130 times – based on 0 reviews     Review now
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            Validity of psoriatic arthritis and capture of disease modifying antirheumatic drugs in the health improvement network.

            Alexis Ogdie, Sara Alehashemi, Thorvardur Love … (2014)
            The aims of this study are to examine the validity of diagnostic codes for psoriatic arthritis in The Health Improvement Network (THIN) and to examine the agreement between General Practitioner (GP) report and prescription records for disease modifying antirheumatic drugs (DMARDs).
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              Accuracy of the diagnoses of spondylarthritides in veterans affairs medical center databases.

              Jasvinder Singh, R Holmgren, Hollis E Krug … (2007)
              To study the accuracy of diagnoses of spondylarthritides in computerized databases at the Minneapolis Veterans Affairs Medical Center. Medical records were available and reviewed for a random sample of 184 patients from a cohort of 737 patients seen at the rheumatology clinic between January 1, 2001 and July 31, 2002. We compared 4 database definitions with the medical record gold standard of rheumatologists' diagnosis of ankylosing spondylitis (AS), psoriatic arthritis (PsA), or reactive arthritis (ReA): presence of 1) > or =1 or 2) > or =2 International Classification of Diseases, Ninth Revision (ICD-9) diagnostic codes for diagnoses of AS (720.0), PsA (696.0), and ReA (099.3, 711.11-711.19), and presence of 3) > or =1 or 4) > or =2 ICD-9 codes and prescription of a disease-modifying antirheumatic drug (DMARD). Accuracy was assessed by sensitivity, specificity, positive predictive values (PPVs) and negative predictive values (NPVs), kappa statistic, and receiver operator characteristic (ROC) curve area. Of 184 patients, 11 (6%) had AS, 17 (9%) had PsA, and 7 (4%) had ReA as per the gold standard. ICD-9 codes for AS, PsA, and ReA were very specific (98-100%) with excellent NPV (99-100%) and PPV (83-100%), good to excellent sensitivity (57-100%), almost perfect kappa agreement (0.72-1), and high ROC curve area (0.79-1). Addition of presence of DMARD prescription to ICD-9 codes of AS and PsA decreased sensitivity to 27-65% without improving the specificity (which was already high at 99-100%). The ICD-9 codes for AS, PsA, and ReA in databases are accurate. ICD-9 codes may be used to identify cohorts of patients with spondylarthritides.
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                Author and article information

                Journal
                Title: Pharmacoepidemiology and Drug Safety
                Abbreviated Title: Pharmacoepidemiol Drug Saf
                Publisher: Wiley
                ISSN: 10538569
                Publication date Created: April 2016
                Publication date (Print): April 2016
                Publication date (Electronic): January 13 2016
                Volume: 25
                Issue: 4
                Pages: 399-404
                Affiliations
                [1 ]Boston University School of Medicine; Section of Rheumatology; Boston MA USA
                [2 ]VA Boston Healthcare System; Boston MA USA
                [3 ]Boston University School of Medicine; Section of Clinical Epidemiology; Boston MA USA
                [4 ]Massachusetts General Hospital; Section of Rheumatology; Boston MA USA
                [5 ]University of Toronto; Toronto Western Hospital; Toronto ON Canada
                Article
                DOI: 10.1002/pds.3952
                PMC ID: 4826861
                PubMed ID: 26762622
                SO-VID: 2c4b2085-1100-4a47-8bfc-3b8f89f780f7
                Copyright © © 2016
                License:

                http://doi.wiley.com/10.1002/tdm_license_1.1

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